Chapter 15 adrenergic Agonist & Antagonist Flashcards
What does the sympathetic nervous system do?
It activates the body
What does the parasympathetic nervous system do?
Slows down the body
What does sympathic function do the following?
Heart? (2)
Blood vessels ?
Lungs ?
GI? (3)
Eyes?
Increase heart rate
Increase force of contraction
Constriction
Bronchodilation
Decrease motility
Sphincter contraction
Decreased secretions ( relax bladder)
Dilation of pupil
What does parasympathetic nervous system do to the body?
Heart?(2)
Blood vessels?
Lungs?
GI? (3)
Eyes?
Decrease heart rate
Decrease force of contraction
No effect
Bronchoconstrction
Increase motility
Sphincter relaxation
Increased secretions
Constriction
How does adrenergic agonist function or react to the central nervous system?
Its functions in causing a sympathetic response & stimulate the sympathies nervous system
What does catecholamines mean?
A substance that can produce a simpathomimetric response
What does sympathomimetric mean?
A drug that affects the sympathetic nervous sustem
What does adrenergic mean?
Stimulates the sympathetic nervous system
What does agonist mean?
A drug that stimulates the action of a receptor
What does antagonist mean?
A drug that blocks response from a receptor
Adrenergic drugs stimulate the sympathetic nervous system, but without this drug, how does our body naturally stimulate this system?
Mimic neurotransmitters like
Norepinephrine and epinephrine
What does adrenergic receptor sites act on?
Heart, bronchi, gi tract, urinary bladder, ciliary eye
Adrenergic drugs are also known as?(2)
Adrenergic agonist
Sympathomimetics
What are the 2 different kind of alpha receptors that adrenergic agonists effect?
Alpha 1
Alpha 2
What does alpha 1 receptors do for adrenergic agonist ? (3)
Increases cardiac contractility, vasoconstriction
Dilate the pupils, increase blood pressure
Increases bladder relaxation & urinary sphincter contractions
What does alpha 2 receptors do to adrenergic agonist? (2)
Promotes vasodilators and decrease BP by preventing the release of norepinephrine
Decrease GI motility & tone
What are the side effects of alpha adrenergic adverse effects?
CNS (5)
Cardiovascular (4)
Other (5)
Headache
Restlessness
Excitement
Insomnia
Euphoria
Palpitations
Tachycardia
Vasoconstriction
Hypertension
Loss of appetite
Dry mouth
Nausea
Vomiting
Taste changes
What are the two beta receptors ?
Beta 1
Beta 2
What does beta 1 receptors do for adrenergic agonists? (2)
Increase cardiac contractility
Increase BP & HR
What does beta 2 receptors do for adrenergic agonists? (5)
Bronchodilation & decrease GI tone
Increase blood flow
Relaxes smooth muscules of uterus
Activates liver glycogenolysis /increase blood glucos
Increase renin secretion in kidneys
Adverse effects of beta adrenergic ?
CNS!(4)
cardiovascular(3)
Other (4)
Mild tremors
Headaches
Nervousness
Dizziness
Increase HR
palpitations
Fluctuations in BP
Sweating
Nausea
Vomitting
Muscle cramps
Where are the dopaminergic receptors? ( this is also where they effect ) (4)
Kidneys
Mesentery
Heart
Brain
Once we have stimulated on of these receptors, we have to inactivate it. Why?
Then we prolong the effect of the stimulation of that receptor
How can we inactive the norepinephrine? (3)
By having the transmitter going back to the neurons & or enzymes that degrade that extra norepinephrine
Or even giving drugs that prolong the action of the neurotransmitter
- by either inhibiting the reuptake
- by inhibit degradation
When we talk about our sympathomimetics or adrenergic agonists they can be classified as 3 things. What are they and give me an example?
Direct ( epinephrine )
- directly stimulates the receptor
Indirect ( amphetamine )
- simulates the release of epinephrine from terminal to be sent to the place
Mixed acting ( ephedrine, psuedoephedrine )
- stimulated receptors
- stimulates release of epinephrine from terminal
What is catecholamines again?
A substance that produces a sympathetic response
What are the 2 groups of catecholamines? Examples too
Endogenous ( epinephrine, norepinephrine & dopamine)
Synthetic catecholamines
( isoproternol, dobutamine )
What does noncatecholamines?
Stimulates the receptors!! and create a response, but they last a little longer
( phenylephrine, albuterol )
What is central acting alpha agonists?
What are the two drugs used/ used for?
Stimulate alpha receptors in the CNS
Clonidine
Methyldipa
( treating hypertension )
Clinical judgement with an adrenergic agonist
Notes!!
Perfusion!
Looking at viral signs & drug history
Hypotension since it’s mainly drugs to help with hypertension
Record the viral signs
Report heart palpitations
Avoid continuous use of nasal sprays no cold medications!!
If you have hypertension and or heart disease avoid these drugs why?
What type of drugs?
Cold medicines
Because they can aggregate it!!
What are adrenergic antagonists?
How do they do this (2)?
Blocks the effects of adrenergic neutrotransmitters
Directly occupying the receptors
Indirectly releasing epinephrine & norepehrine
What are the types of adrenergic antagonists?
Alpha & beta
Selective and nonselective
What is the difference between selective and nonselective?
Selective will only effect alpha 1/2 and beta 1/2
However with nonselective it effects every alpha and beta receptors
What does alpha adrenergic antagonist do?
Selective example?
Nonselective example?
Actions?
Usage?
Drugs that inhibit a response at alpha adrenergic receptor site
Blocks alpha 1
Blocks both alpha 1
Promotes vasodilations
Decrease BPH&PVD
( peripheral vascular disease )
( Benin prostate hyperplasia)
Alpha 1 side effects (6)
Vasodilations & dizziness
Orthostatic hypotension
Pupil constrictions
Suppresses ejaculation
Reduce contraction of smooth muscles in bladder
If a patient is on an alpha 1 adrenergic antagonist, why do we want to put them on a risk fall precaution or education them on changing positions slowly?
Because of the orthostatic hypotension
What does beta adrenergic antagonists do!?
( these are beta blockers!)
Nonselective
beta blocker 1 (2)
Blocks 2 (2)
Example of nonselective ^
Decrease blood pressure & heart rate
Decreases BP & heart rate
Bronchocontrxrions & use with caution in patients with COPD&asthma
Atenolol
( chest pain really! )
Why do we want to watch out with patients with chronic respiratory disease when on a nonselective beta blocker?
Respiratory disease will get worse
Stronger consider to change it
Notes
Beta1
Reduce heart contractions & HR
Beta 2
Bronchospams
Contracts uterus
Inhibits glucohenolysis
( leads with hypoglycemia $
Beta blockers 2, people are at risk for developing hypoglycemia why?
Because it inhibits glycogenolysis
Some of our beta blockers have intrinsic sympathomimetic activity, which means that?
And can be used for people who have problems with?
Then how does it help them?
Even though they are blocking the receptors, there is a small activity
Bradycardia
Since hypertension medications will lower there heart rate; they usually have bradycardia problems, so we have drugs with this activity to help promote low blood pressure while still having some activation of the heart from the little stimulation
Notes
Selective blockers
- metoprolol
- decrease blood pressure
Beta adrenergic blockers ( beta blockers )
Have drug interactions
How do they work with NSAIDS?
How do they work with other antihyperneeive medications ?
They show decrease effects with NSAIDS
they show increase effective with other antihypertensive medications ( like higher risk for hypotension )
What are side effective if beta blockers? (4)
Bradycardia!!
Hypotension !!
Dysrthythmias
Palpitations !!
Dizziness
Depression
Peripheral edema !!
What is adrenergic neuron antagonists?
What are they used for ?
Block the release of norepinephrine
Decrease blood pressure
Notes
Example of adrenergic neuron antagonists?
Reserpine
Reduces the serotionin and catecholamines transmitters
Depletion of these neurotransmitters may lead to severe mental depression
